[Congressional Record Volume 143, Number 155 (Friday, November 7, 1997)]
[Senate]
[Pages S12006-S12007]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. FEINSTEIN (for herself and Mr. Kyl):
  S. 1420. A bill to amend the Illegal Immigration Reform and Immigrant 
Responsibility Act of 1996 to provide for full reimbursement of States 
and localities for costs related to providing emergency medical 
treatment to individuals injured while entering the United States 
illegally; to the Committee on the Judiciary.


 THE ILLEGAL ALIEN EMERGENCY MEDICAL SERVICES REIMBURSEMENT ACT OF 1997

  Mrs. FEINSTEIN. Mr. President, I am offering legislation with Senator 
Kyl as original cosponsor, a legislation which provides full 
reimbursement to state and local counties for costs incurred for 
emergency medical services and ambulatory services provided to 
undocumented aliens injured during a pursuit by border patrol or under 
the custody of federal, state, or local authorities.
  This legislation: Authorizes full reimbursement for emergency medical 
costs, including ambulatory services for illegal aliens who are injured 
during illegal crossings at land and sea ports, or during a pursuit by 
border patrol, or while in custody of federal, state, or local 
authorities;
  Authorizes up to $18 million per year for the next 4 years from a 
separate account under the Attorney General to reimburse states and 
localities for emergency medical services provided to illegal aliens.
  Requires the Attorney General to submit a written report to Senate 
and House Judiciary Committees on the policy and practice, including 
custody practice, of the border patrol by March 1, 1998.
  Requires annual report by the Attorney General to Senate and House 
Judiciary and Appropriations Committees on the implementation of this 
bill.
  INS reports show that in FY96, 1.65 million illegal aliens were 
apprehended, of which 97% or 1.6 million apprehensions were made at the 
Southwest Border. INS also reports that more than 300,000 illegal 
aliens come into the country every year and in FY97, over 111,000 
criminal and other illegal aliens were put through formal deportation 
proceedings.
  With increased focus on apprehending illegal aliens at the 140 mile 
stretch of our Southwest border, recent reports also show increases in 
unreimbursed emergency medical service cost of illegal aliens to state 
and local county hospitals.
  The California State Auditor recently released a report which charged 
that San Diego alone incurred up to $8.1 million in unreimbursed 
charges in emergency medical service for illegal aliens between January 
1996 and May 1997. The Auditor estimates that San Diego hospitals 
incurred from $4.9 million to $8.1 million in unreimbursed emergency 
medical services and ambulatory services for up to 1074 illegal aliens 
during the seventeen month period. The unreimbursed medical service 
costs include hospital care, costs incurred for paramedics and air 
transportations, physicians, surgeons and laboratories. These 
uncompensated services, which hospitals and other emergency service 
providers are required to

[[Page S12007]]

provide under California law, were provided to illegal aliens who were 
injured during illegal crossings at the border and while escaping 
border patrol pursuits.

  The Sacramento Bee recently reported the following:

       Every time a Border patrol chase results in injuries, San 
     Diego area hospitals provide `free' care to those injured... 
     (For instance), medical care for Fransciso Quintera--who was 
     struck by a car while fleeing Border patrol agents--cost UCSD 
     Medical Center over $1 million in uncompensated expenses. In 
     one recent vehicle chase, a van loaded with illegal 
     immigrants crashed while evading the Border Patrol, costing 
     Scripps Hospital $200,000 and Mercy Hospital $100,000 in 
     uncompensated care.

  In the 1996 Immigration Act, Congress acknowledged the huge cost 
shift to state and local county hospitals in unreimbursed cost for 
emergency medical services provided to illegal aliens by authorizing 
full reimbursement for emergency Medicaid and ambulatory services.
  However, the $25 million appropriated annually over the next 4 years 
under the Balance Budget Act for emergency Medicaid for illegal aliens 
is insufficient to cover the full cost of emergency medical services 
for illegal aliens nationwide, where high immigrant States like 
California, Texas, New York, Florida, Illinois, New Jersey, Arizona and 
Massachusetts end up picking up the responsibility for caring for the 
injured illegal aliens.
  In fact, for fiscal year 1998, there are no appropriations for 
reimbursement for emergency ambulatory services, as authorized by the 
1996 Immigration Act. Instead, Congress only requires INS to perform a 
pilot project in Nogales, Arizona and report its findings to Congress.
  Appropriating $25 million over the next 4 years and performing a 
pilot project in Nogales, Arizona is not enough to cover the millions 
of dollars high immigrant States like California incur every year in 
unreimbursed emergency medical and ambulatory costs for illegal aliens 
injured at the border or during a border patrol pursuit.
  Mr. President, time has come for the Federal Government to take full 
responsibility for the cost associated with providing emergency medical 
services, including ambulatory services, for illegal aliens and lifting 
the fiscal burden on State and local counties.
  Thank you and I urge all my colleagues to support this legislation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1420

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. AMENDMENT OF THE ILLEGAL IMMIGRATION REFORM AND 
                   IMMIGRANT RESPONSIBILITY ACT OF 1996.

       Section 563 of the Illegal Immigration Reform and Immigrant 
     Responsibility Act of 1996 is amended to read as follows:

     ``SEC. 563. REIMBURSEMENT OF STATES AND LOCALITIES FOR 
                   EMERGENCY MEDICAL SERVICES.

       ``(a) Subject to the availability of appropriations, the 
     Attorney General shall fully reimburse States and political 
     subdivisions of States for their costs of providing medical 
     services, including ambulatory services, related to an 
     emergency medical condition of an individual who--
       ``(1) is injured while, or being pursued immediately after, 
     crossing a land or sea border of the United States without 
     inspection or at any time or place other than as designated 
     by the Attorney General; and
       ``(2) is under the custody of the State or subdivision 
     pursuant to a transfer, request, or other action by a Federal 
     authority.
       ``(b) There is established in the general fund of the 
     Treasury a separate account out of which the Attorney General 
     shall provide reimbursement under this section.
       ``(c) Reimbursement under this section shall not be taken 
     out of monies appropriated for the Immigration and 
     Naturalization Service.
       ``(d) There are authorized to be appropriated for fiscal 
     years 1998-2002 an amount not to exceed $18,000,000 annually 
     for the purpose of carrying out this section.
       ``(e) The Attorney General shall report to the Judiciary 
     and Appropriations Committees of the House of Representatives 
     and the Senate annually on the implementation of this 
     section.
       ``(f) By March 1, 1998, the Attorney General shall submit a 
     written report to the Judiciary Committees of the House of 
     Representatives and Senate on the policy and practice, 
     including custody practice, of the United States Border 
     Patrol with respect to injured aliens.
       ``(g) For purposes of this section, the term `emergency 
     medical condition' has the same meaning as that term has 
     under section 562 of the Illegal Immigration Reform and 
     Immigrant Responsibility Act of 1996.''.
                                 ______